Academic literature on the topic 'Let nobody turn us around'

The cold war, many people contend, ended sometime around 1989. A number of facts, such as the United States' military hegemony, the demise of the Soviet empire, and China's impeccable capitalist record, tend to corroborate this contention. Yet, with all due respect to the memory of John Adams, stubbornness is not the privilege solely of facts. Certain mind-sets can prove just as obstinate. Dormant or sidestepped during most of the 1990s, cold war mentalities and their mantras—“trace all evil to the main enemy,” “don't let your base be troubled by nuance and ambiguity”—have indeed made a great comeback since the beginning of the new millennium, and their mouthpieces are working hard to turn George W. Bush's post-9/11 pronouncement “You are either with us or you are against us …” into a self-fulfilling prophecy (“President”). To ward off the return of these disciplinary strictures, it is tempting to resort to probably the most powerful cold war remedy of the 1970s and 1980s—namely, human rights discourse and activism. Has this remedy retained its potency in the current context? Addressing this question—or at least stressing its urgency—is the main ambition of the following pages.

Introduction Such symptoms as hard, complex, bodily or mental feelings, that turn our everyday life into a hell, at first, lead us to a doctor, and then - to a psychotherapist. A sick man is keen to get rid of a symptom. A doctor prescribes medication, that is ought to eliminate a symptom. A psychotherapist searches for a reason of the problem that needs to be removed. There is such an idea that a neurotic symptom, in particular, an anxiety - is a pathological (spare or extra) response of a body. It is generally believed that such anxiety doesn’t have some real, objective reasons and that it is the result of a nervous system disorder, or some disruption of a cognitive sphere etc. Meanwhile, it is known that in the majority of cases, medical examinations of anxious people show that they don’t have any organic damages, including nervous system. It often happens that patients even wish doctors have found at least any pathology and have begun its treatment. And yet - there is no pathology. All examinations indicate a high level of functionality of a body and great performance of the brain's work. Doctors throw their hands up, as they can't cure healthy people. One of my clients told me her story of such medical examinations (which I’ll tell you with her permission). She said that it was more than 10 years ago. So, when she told her doctor all of her symptoms - he seemed very interested in it. He placed a helmet with electrodes on her head and wore some special glasses, when, according to her words, he created some kind of stressful situation for her brain, as she was seeing some flashings of bright pictures in her eyes. She said that he had been bothered with her for quite a long time, and at the end of it he had told her that her brain had been performing the best results in all respects. He noted that he’d rarely got patients with such great health indicators. My client asked the doctor how rare that was. And he answered: “one client in two or three months.” At that moment my client didn’t know whether to be relieved, flattered or sad. But since then, when someone told her that anxiety was a certain sign of mental problems, or problems with the nervous system, or with a body in general, she answered that people who had anxiety usually had already got all the required medical examinations sufficiently, and gave them the advice to go through medical screening by themselves before saying something like that. Therefore, we see a paradoxical situation, when some experts point to a neurotic anxiety as if it is a kind of pathology, in other words - some result of a nervous system disorder. Other specialists in the same situation talk about cognitive impairments. And some, after all the examinations, are ready to send such patients into space Main text I don’t agree with the statement that any neurotic anxiety that happens is excessive and unfounded. It often happens that there is objective, specific and real causes for appearance of anxiety conditions. And these causes require solutions. And it’s not about some organic damages of the brain or nervous system. The precondition that may give a rise to anxiety disorder is the development of such a life story that at some stage becomes too toxic - when, on the one hand, a person interacts with the outside world in a way that destroys his or her personality, and, on the other hand, this person uses repression and accepts such situation as common and normal. Repression - is an essential condition for the development of a neurotic symptom. Sigmund Freud was the first who pointed this out. Repression is such a defense mechanism that helps people separate themselves from some unpleasant feelings of discomfort (pain) while having (external or internal) irritations. It is the situation when, despite the presence of irritations and painful feelings, a person, however, doesn't feel any of it and is not aware of them in his or her conscious mind. Repression creates the situation of so-called emotional anesthesia. As a result, a displacement takes place, so a body starts to signal about the existing toxic life situation via a symptom. Anxiety disorder is usually an appropriate response (symptom) of a healthy body to an unhealthy life situation, which is seen by a person as normal. And it’s common when such a person is surrounded by others (close people), who tend to benefit from such situation, and so they actively maintain this state of affairs, whether it is conscious for them or not. At the beginning of a psychotherapy almost all clients insist that everything is good in their lives, even great, as it is like in everyone else’s life. They say that they have only one problem, which is that goddamn symptom. So they focus all of their attention on that symptom. They are not interested in all the other aspects of their life, and they show their irritation when it comes to talking about it. People want to get rid of it, whatever it takes, but they often tend to keep their lives the way that it was. In such cases a psychotherapist is dealing with the resistance of clients, trying to turn their attention from a symptom to their everyday situation that includes their way of thinking, interactions with themselves and with others and with the external world in order to have the opportunity to see the real problem, to live it through, to rethink and to change the story of their lives. For better understanding about how it works I want to tell you three allegorical tales. The name of the first tale is “A frog in boiling water”. There is one scientific anecdote and an assumption (however, it is noted that such experiments were held in 19 century), that if we put a frog in a pot with warm water and start to slowly heat the water, then this frog get used to the temperature rise and stays in a hot water, the frog doesn’t fight the situation, slowly begins to lose its energy and at the last moment it couldn’t find enough strength and energy to get out of that pot. But if we throw a frog abruptly in hot water - it jumps out very quickly. It is likely that a frog, that is seating in boiling water, will have some responses of the body (symptoms). For example, the temperature of its body will rise, the same as the color of it, etc., that is an absolutely normal body response to the existing situation. But let us keep fantasizing further. Imagine a cartoon where such a frog is the magical cartoon hero, that comes to some magical cartoon doctor, shows its skin, that has changed the color, to the doctor, and asks to change the situation by removing this unpleasant symptom. So the doctor prescribes some medication to return the natural green color of the frog’s skin back. The frog gets back in its hot water. For some period of time this medication helps. But then, after a while, the frog’s body gets over the situation, and the redness of the frog's skin gets back. And the magical cartoon doctor states that the resistance of the body to this medication has increased, and each time prescribes some more and more strong drugs. In this example with the frog it is perfectly clear that the true solution of the problem requires the reduction of the water temperature in that pot. We could propose that magical cartoon frog to think and try to realize that: 1) the water in that pot is hot, and that is the reason why the skin is red; 2) the frog got used to this situation and that is why it is so unnoticeably for this frog; 3) if the temperature of the water in the pot still stay so hot, without any temperature drop, then all the medication works only temporarily; 4) if we lower the temperature in that pot - the redness disappears on its own, automatically and without any medication. Also this cartoon frog, that will go after the doctor to some cartoon physiotherapist, will face the necessity to give itself some answers for such questions as: 1) What is going on? Who has put this frog in that pot? Who is raising the temperature progressively? Who needs it? And what is the purpose or benefit for this person in that? Who benefits? 2) Why did the frog get into the pot? What are the benefits in it for the frog? Or why did the frog agree to that? 3) What does the frog lose when it gets out of this pot? What are the consequences of it for the frog? What does the frog have to face? What are the possible difficulties on the way? Who would be against the changes? With whom the frog may confront? 4) Is the frog ready to take control over its own pot in its own hands and start to regulate the temperature of the water by itself, so to make this temperature comfortable for itself? Is this frog ready to influence by itself on its own living space, to take the responsibility for it to itself? The example “A frog in boiling water” is often used as a metaphorical portrayal of the inability of people to respond (or fight back) to significant changes that slowly happen in their lives. Also this tale shows that a body, while trying to adjust to unfavorable living conditions, will react with a symptom. And it is very important to understand this symptom. Symptom - is the response of a body, it’s a way a body adjusts to some unfriendly environment. Symptom, on the one hand, informs about the existence of a problem, and from the other hand - tries to regulate this problem, at least in some way (like, to remove or reduce), at the level on which it can do it. The process is similar to those when, for example, in a body, while it suffers from some infectious disease, the temperature rises. Thus, on the one hand, the temperature informs about the existence of some infection. On the other hand, the temperature increase creates in a body the situation that is damaging for the infection. So, it would be good to think about in what way does an anxiety symptom help a body that is surrounded by some toxic life situation. And this is a good topic for another article. Here I want to emphasize that all the attempts to remove a symptom without a removal of a problem, without changing the everyday life story, may lead to strengthening of the symptom in the body. Even though the removal of a symptom without elimination of its cause has shown success, it only means that the situation was changed into the condition of asymptomatic existence of a problem. And it is, in its essence, a worse situation. For example, it can cause an occurrence of cancer. The tale “A frog in boiling water” is about the tendency of people to treat a symptom, instead of seeing their real problems, as its cause, and trying to solve it. People don’t want to see their problems, but it doesn’t mean that the problem doesn’t exist. The problem does exist and it continues to destroy a person, unnoticeably for him or her. A person with panic disorder could show us anxiety that is out of control (fear, panic), which, by its essence, seems to exist without any logical reason. Meanwhile the body of such a person could be in such processes that are similar to those that occur in the conditions of some real dangers, when the instinct for self-preservation is triggered and an automatic response of a body to fight or flight implements for its full potential. We can see or feel signs of this response, for example, in cases when some person tries to avoid some real or imaginary danger via attempts to escape (the feeling of fear), or tries to handle the situation by some attempts to fight (the feeling of anger). As I mentioned before, many doctors believe that such fear is pathological, as there is no real reason for such intense anxiety. They may see the cause of the problem in worrisome temper, so they try to remove specifically anxiety rather than help such patients to understand specific reason of their anxiety, they use special psychotherapeutic methods that are designed to help clients to develop logical thinking, so it must help them to realize the groundlessness of their anxiety. In my point of view, such anxiety often has specific, real reasons, when this response of a body, fight or flight, is absolutely appropriate, but not excessive or pathological. Inadequacy, in fact, is in the unconsciousness, but not in the reactions of a body. For a better understanding of the role of anxiety in some toxic environment, that isn’t realized, I want to tell you another allegorical tale called “The wolf and the hare”. Let us imagine that two cages were brought together in one room. The wolf was inside one cage and the hare was in another. The cages were divided by some kind of curtain that makes it impossible for them to see each other. At this point a question arises whether the animals react to each other in some way in such a situation, or not? I think that yes, they will. Since there are a lot of other receptors that participate in the receiving and processing of the sensory information. As well as sight and hearing, we have of course a range of other senses. For example, animals have a strong sense of smell. It is well known that people, along with verbal methods of communicating information, like language and speaking, also have other means of transmitting information - non-verbal, such as tone of voice, intonation, look, gestures, body language, facial expressions etc., that gives us the opportunity to receive additional information from each other. The lie detector works by using this principle: due to detecting non-verbal signals, it distinguishes the level of the accuracy of information that is transmitted. It is assumed, that about 30% of information, that we receive from the environment, comes through words, vision, hearing, touches etc. This is the information that we are aware of in our consciousness, so we could consciously (logically) use it to be guided by. And approximately 70% of everyday information about the reality around us we receive non-verbally, and this information in the majority of cases could remain in us without any recognition. It is the situation when we’ve already known something, and we even have already started to respond to it via our body, but we still don’t know logically and consciously that we know it. We can observe the responses of our own body without understanding what are the reasons for such responses. We can recognize this unconscious information through certain pictures, associations, dreams, or with the help of psychoanalysis. Psychoanalysis is a great tool that can help to recognize the information from the unconscious mind, so that it can be logically processed further on, in other words, a person then receives the opportunity to indicate the real problems and to make right decisions. But let us return to the tale where the hare and the wolf stay in one room and don’t see each other, and, maybe, don’t hear, though - feel. These feelings (in other words - non-verbal information that the hare receives) activate a certain response in the hare’s body. And it reacts properly and adequately to the situation, for instance, the body starts to produce adrenaline and runs the response “fight or flight”. So the hare starts to behave accordingly and we could see the following symptoms: the hare is running around his cage, fussing, having some tremor and an increased heart rate, etc.. And now let us imagine this tale in some cartoon. The hare stays in its house, and the wolf wanders about this house. But the hare doesn’t see the wolf. Though the body of the hare gives some appropriate responses. And then that cartoon hare goes to a cartoon doctor and asks that doctor to give it some pill from its tremor and the increased heart rate. And in general asks to treat in some way this incomprehensible, confusing, totally unreasonable severe anxiety. If we try to replace the situation from this fairy-tale to a life story, we could see that it fits well to the script of interdependent relationships, where there are a couple “a victim and an aggressor”, and where such common for our traditional families’ occurrences as a domestic family violence, psychological and physical abuse take place. Only in 2019 a law was passed that follows the European norms and gives a legislative definition of such concepts as psychological domestic abuse, sexual abuse, physical abuse, bullying, that criminalizes all of these occurrences, establishes the punishment and directly points to people that could be a potential abuser. Among them are: a husband towards his wife, parents towards their children, a wife towards her husband, a superior towards a subordinate, a teacher towards his or her students, children towards each other etc.. When it comes to recognition of something as unacceptable, it seems more easy to put to that category such occurrences as physical and sexual abuse, as we could see here some obvious events. For example, beating or sexual harassment. Our society is ready to respond to these incidents in more or less adequate way, and to recognize them as a crime. But it is harder to deal with the recognition of psychological abuse as an offence. Psychological abuse in our families is common. Psychological abuse occurs through such situations, when one person, while using different psychological manipulations, such as violation of psychological borders, imposition of feeling of guilty or shame, etc., force another person to give up his or her needs and desires, and so in such a way make this person live another’s life. Such actions have an extremely negative effect on the mental health of these people, just as much as physical abuse. It can destroy a person from the inside, ruin self-esteem and a feeling of self-worth, create the situation of absolute dependence such victim from an abuser, including financial dependence etc.. It often happens that psychological abuse takes place against the backdrop of demonstrations of care and love. So you've got this story about the wolf and the hare, that are right next to each other, and the shield between two of them is a repression - a psychological defense mechanism, when a person turns a blind eye to such offences, that take place in his or her own life and towards him or her. And this person considers this as normal, doesn't realize, doesn't have a resource to realize, that it is a crime. Most importantly - doesn’t feel anything, as a repression takes place. But a body responds in a right way - from a certain point of the existence of such a toxic situation the response “fight or flight” is launched in a body at full, in other words - the fear and anxiety with the associated symptoms. The third allegorical tale I called “Defective suit”, which I read in the book of Clarissa Pinkola Estés with the name “Running With the Wolves". “Once one man came to a tailor and started to try on a suit. When he was standing in front of a mirror, he saw that the costume had uneven edges. - Don’t worry, - said the tailor. - If you hold the short edge of the suit by your left hand - nobody notices it. But then the man saw that a lapel of a jacket folded up a little bit. - It's nothing. You only need to turn your head and to nail it by your chin. The customer obeyed, but when he put on trousers, he saw that they were pulling. - All right, so just hold your trousers like this by your right hand - and everything will be fine, - the tailor comforts him. The client agreed with him and took the suit. The next day he put on his new suit and went for a walk, while doing everything exactly in the way that the tailor told him to. He waddled in a park, while holding the lapel by his chin, and holding the short edge of the suit by his left hand, and holding his trousers by his right hand. Two old men, who were playing checkers, left the game and started to watch him. - Oh, God! - said one of them. - Look at that poor cripple. - Oh, yes - the limp - is a disaster. But I'm wondering, where did he get such a nice suit?” Clarissa wrote: “The commentary of the second old man reflects the common response of the society to a woman, who built a great reputation for herself, but turned into a cripple, while trying to save it. “Yes, she is a cripple, but look how great her life is and how lovely she looks.” When the “skin” that we put on ourselves towards society is small, we become cripples, but try to hide it. While fading away, we try to waddle perky, so everyone could see that we are doing really well, everything is great, everything is fine”. As for me, this tale is also about the process of forming a symptom in a situation when one person tries very hard to match to another one, whether it is a husband, a wife or parents. It’s about a situation when such a person always tries to support the other one, while giving up his or her own needs and causing oneself harm in such a way by feeling a tension every day, that becomes an inner normality. And so this person doesn’t give oneself a possibility to relax, to be herself (or himself), to be spontaneous, free. As a result, in this situation the person, who was supported, looks perfect from the outside, but those who tried to match, arises some visible defect, like a limp - a symptom. And so this person lives like a cripple, under everyday stress and tension, trying to handle it, while sacrificing herself (or himself) and trying to maintain this situation, so not to lose the general picture of a beautiful family and to avoid shame. The tailor, who made this defective suit and tells how to wear the suit properly, in order to keep things going as they are going, often is a mother who raised a problematic child and then tells another person how to deal with her child in the right way. It is the situation when a mother-in-law tells her daughter-in-law how to treat her son properly. In other words, how to support him, when to keep silent, to handle, how to fit in, so that her problematic son and this relationship in general looks perfect. Or vice versa, when a mother-in-law tells her son-in-law how to support her problematic daughter, how to fit in etc.. When, for example, a woman acts like this in her marriage and with her husband, with these excessive efforts to fit in - then after a while everybody will talk like: “Look at this lovely man: he lives with his sick wife, and their family seems perfect!”. But when such a woman becomes brave enough to relax and to just let the whole thing go, everybody will see that the relationship in her marriage isn’t perfect, and it is the other one who has problems. Each time when someone tries excessively to match up to another one, while turning oneself in some kind of a cripple, - he or she, on the one hand, supports the comfort of that person, to whom he or she tries to match up, and on the other hand - such a situation always arises in that person such conditions as a continuous tension, anxiety, fear to act spontaneously. A symptom - is like a visible defect, that shows itself through the body (and may look like some kind of injury). It is the result of a hidden inner prison. As a result of evolution, a pain tells us about a problem that is needed to be solved. When we repress our pain we can’t see our needs and our problems at full. And then a body starts to talk to us via a symptom. Psychotherapy aims for providing a movement from a symptom to a resumption of sensitivity to feelings, a resumption of the ability to feel your psychological pain, so you can realize your own toxic story. In this perspective another fairy-tale looks interesting to analyze - it is Andersen's fairytale “Princess and the Pea”. In the tale a prince wanted to find a princess to marry. There was one requirement for women candidates, so the prince could select her among commoner - high level of sensitivity, as the real princess would feel a pea through the mountain of mattresses, and so she could have the ability to feel discomfort, to be in a good contact with her body, to tell about her discomfort without such feeling as shame and guilt, and to refuse that discomfort, so to have the readiness to solve her problems and to demand from others the respect for her needs. It is common for our culture that the expression “a princess on a pea” very often uses for a negative meaning. So people who are in good contact with their body and who can demand comfort for themselves are often called capricious. At the same time the heroes who are ready to suffer and to tolerate their pain, who are able to repress (stop to feel) their pain represents a good example to be followed in our society. So, we may see the next algorithm in cases of various anxiety disorders: the existence of some toxic situation that brings some danger to a person. And we need not to be confused: a danger exists not for a body, but for a personality. A toxic live situation as well as having a panic attack is not a threat for the health of a body (that is what medical examinations show), and vice versa - it’s like every day intensive sport training, that could be good for your health only to some degree. A toxic situation destroys a person as a personality, who longs for one self’s expression; the existence of such a defense mechanism as repression - it’s a life with closed eyes, in pink glasses, when there is inability (or the absence of the desire) to see its own toxic story; 3.the presence of a symptom - a healthy response of a body “fight or flight” to some toxic situation; displacement - it’s replacement of the attention from the situation to a symptom, when a person starts to see and search for the problem in some other place, not where it really is. A symptom takes as some spare, pathological reaction that we need to get rid of. The readiness to fight the symptom arises, and that is the goal of such methods of therapy as pharmacological therapy, CBT and many others; the absence of adequate actions that are directed towards the change of a toxic situation itself. The absence of the readiness to show aggression when it comes to protect its space. All of it is a mechanism of formation of primary anxiety and preparation for launch of secondary anxiety. A complete anxiety disorder is the interaction between a primary and a secondary anxiety.

Background This study examines the contagion effect on shareholders’ wealth of large generic firms to the issuance of guidelines by the Office of Inspector General “to efficiently monitor adherence to applicable statutes, regulations and program requirements” of the branded pharmaceutical companies. These guidelines prod pharmaceutical manufacturers to employ internal controls and self-regulation while marketing to the physicians. Methods We use a standard event-study methodology to measure the effect on the value of nine large generic firms around four events including the final guidance issued by Office of Inspector General. Results The results show that there is a contagion effect with an overall loss in net wealth of large generic firms’ shareholders. The US government’s policy guidance necessitated pharmaceutical industry to reexamine and refine for the better, its marketing practices. The government achieved this change in pharmaceutical industry’s behaviour without actually introducing any regulation suggesting the efficacy of self-regulation. Conclusions Our findings suggest that there is a contagion effect of Office of Inspector General guidelines on generic drug industry due to facilitated self-regulation by branded pharmaceutical industry. Thus, the direct implication is that any regulatory event that is meant for one firm or a group of firms in the health sector could adversely impact peer firms in the same industry (pharmaceutical) or related industries such as biotechnology or generic industries. In other words, the study shows that government’s public policy initiatives that effect the value of the targeted firms could change not only the firms’/industry’s behavior but also let government achieve its objectives without contemplating additional regulations. This in turn, may accrue significant cost savings for the government in avoiding the regulation and its related measures. Our results also support an argument that a mechanism that combines industry self-regulation with government monitoring, lends the greatest opportunity for the overall welfare of the society.

“And so, light your face up with a smile, Why waste your life on something really not worthwhile, Look up to the stars, take your eyes off the ground, Come, live your life, turn around.”1 As Doctors of Medicine we should be no strangers to aspiration; “a striving after something higher than oneself” that “usually implies that the striver is thereby ennobled.”2 Aspiration in this context truly earns us the full connotation of the title “Doctor,” as eminent, authoritative, learned healers and teachers of the art and science of medicine. Many among us deserve this title in word and deed, and are worthy of emulation. Their personal and professional lives bear witness, not to self-serving accomplishments, but to their improving life and living in the world around them. Aspiration may be synonymous with ambition, although the latter term which “applies to the desire for personal advancement” may equally suggest “a praiseworthy or an inordinate desire … for rank, fame or power.” 2 Ambition of this sort often resorts to manipulation to achieve its ends, and manipulation in this context is “to control or play upon by artful, unfair, or insidious means especially to one's own advantage.” 3 Whether subtly stolen or brazenly grabbed at the expense of others, the means is often distorted to justify the end. In the process, rights are trampled, dreams shattered, alliances betrayed and relationships severed. According to Messina and Messina4, manipulation is a set of behaviors whose goal is to: Get you what you want from others even when the others are not willing initially to give it to you. Make it seem to others that they have come up with an idea or offer of help on their own when in reality you have worked on them to promote this idea or need for help for your own benefit. Dishonestly get people to do or act in a way which they might not have freely chosen on their own. "Con'' people to believe what you want them to believe as true. Get "your way'' in almost every interaction you have with people, places, or things. Present reality the way you want others to see it rather than the way it "really is.'' Hide behind a "mask'' and let people see you in an acceptable way when in reality you are actually feeling or acting in an ``unacceptable'' way for these people. Maintain control and power over others even though they think they have the control and power. Manipulation also means “to change by artful or unfair means so as to serve one's purpose” or, shameful as it may sound, to “doctor.”3 This derogatory use of the term is not untainted by our actions, whether the arena be laboratory or operating theatre, clinic or lecture hall, hospital or home, interest group or organization, community or society. Blind ambition may delude us into rationalizing dodgy deals and shady maneuverings, convincing even ourselves that they are beneficent and non-maleficent. We get our way, oblivious to the injustice and injury wrought on others. When shameless machinations, “scheming, crafty actions or artful designs intended to accomplish some usually evil end”5 are engaged in by supposed practitioners of the healing art, they do more than validate the colloquial dinu-doktor or dinuktor; they invalidate the rest of us.

If one has a passion for the planet, then this is the right time to drastically lower the carbon emissions. A carbon footprint is the total amount of greenhouse gases (including carbon dioxide and methane) that are generated by our actions. The average carbon footprint for a person in the United States is 16 tons, one of the highest rates in the world. Some carbon emissions will probably never be eradicated entirely from certain industries, such as air travel or construction. When emissions cannot be further reduced, carbon offsetting is the next best thing, says Winters (1). Offsetting emissions is paying for or investing in organisations that can extract carbon from the atmosphere to help others reduce their footprint. It could include investing in reforestation projects or new technologies that suck carbon out of the atmosphere and sequester it underground permanently, technologies to replace jet fuel with alternative green fuels, or switching fossil-fuel-powered facilities with hydrogen-powered facilities. Unless the global economy meets the aims of the Paris Agreement, keeping climate change well below 2°C, the world is expected to suffer extreme weather conditions leading to mass migration and global catastrophe. The argument for global companies to reduce their greenhouse gas (GHG) emissions is clearer than it has ever been. Business operations around the world are now subject to greater climate and transition risks. Consumers are insisting for eco-friendly products and responsible corporate behaviours. Investors are increasingly embracing capital-allocation strategies that take environmental, social, and governance (ESG) issues into account. Policy makers and government organizations are exploring the potential regulation of carbon emissions. The more aggressive the targets, the better the results. In COP26 climate summit in Glasgow held in November 2021, it was made clear that the current climate crisis has been precipitated by unsustainable lifestyles and wasteful consumption patterns mainly in the developed countries. The world needs to awaken to this reality. Globally, the building and construction sectors account for nearly 40% of global energy-related carbon dioxide emissions in constructing and operating buildings (2). Current building codes address operating energy but do not typically address the impacts of embodied carbon in building materials and products. However, more than half of all GHG emissions is related to materials management (including material extraction and manufacturing) when aggregated across industrial sectors (3). In order to reduce our carbon footprint, we can start an eco-friendlier life. In winter, instead of heating, insulate the loft and walls which will make sure our home retains heat during the winter and stays cool in summer. By switching to a company that provides electricity from solar, wind, or hydroelectric energy, we can reduce our household emissions. Buy energy efficient electrical appliances. Additionally, make sure to turn off and unplug anything we are not using. It takes energy and resources to process and deliver water to our homes. So, by using less water, we can help the environment and lower our carbon footprint. The food we eat can have a significant impact on the environment. For example, meat and dairy products require a lot of land, water and energy to produce. They also create a lot of methane, a greenhouse gas. Moreover, food shipped from overseas uses a lot more resources than local produce. By eating fewer animal products, especially red meat, (or choosing a plant-based diet) and shopping for locally sourced food, we can make a big difference. Why not support our local farmers’ market? Powering empty rooms and office space is a huge energy drain. By making sure we turn off lights and appliances when they are not in use, we can make sure we are not wasting power. we can also request to install automatic, movement-sensing lights and energy-saving LED bulbs to address the issue. It has never been easier to collaborate with others online. Whether through sharing documents using cloud storage or video conferencing instead of travelling, we can reduce our waste and emissions. Try moving away from printed documents where possible, and encourage others to work on their digital skills for the workplace. Cycling and walking are two of the most environmentally friendly ways to travel. And, not only are they good for the planet, but they are also good for our health. If we can, choose to cycle or walk to work where possible. ‘Reduce, reuse, recycle’ is a popular slogan. Companies of all sizes use a host of different products in their day-to-day running. Whether it has things like paper, electronic devices, packaging, or water, it all has a carbon footprint. By reducing the amount of waste, we generate, reusing IT equipment, and recycling waste, we can make a real difference. Single use plastics may be convenient, yet they are fairly dreadful for the environment. Not only do they pollute our waterways and oceans, but they also require energy to produce and recycle. We can stop using things like disposable coffee cups and cutlery to reduce our company’s carbon footprint. Instead of preaching, let us practise and bring a change.

This chapter examines how the global search for sexual variation across different historical and cultural contexts helped British and German scholars to move away from the narrow medical focus of early sexology—in which sexual deviance and criminality had figured prominently—to better understand the unstable relation between the healthy and the pathological, and the normal and abnormal. The chapter first charts and explains the global turn in British and German sexual science during the late nineteenth and early twentieth centuries before discussing how sexual scientists from both countries, using historical and anthropological evidence, were able to differentiate between sexual pathology and sexual perversion. British and German sexual scientists also proved that some perversions were normal and could be found in healthy individuals.

To paraphrase the first advertisement for my first book (“Crisis is a terrifying novel. But don’t let that scare you”), this book is about the noble gases. But don’t let that scare you. It’s really about how science works. There is a general misapprehension about this. Most people, without thinking about it, visualize the universe as a railroad track disappearing into the distance, and science as the locomotive slowing wending its way along the track, learning year by year more and more about this universe in which we live. Not so. It would be more realistic to visualize the universe as a black forest hidden on a cloud-obscured night, with science as a lost child trying to find its way home, feeling blindly the branches of the trees, occasionally being slapped in the face by one, tripping over the roots of another, stumbling on a path and taking it eagerly only to find it branching or, worse, precipitately ending. Nothing to do then but turn around and go back, find another branch, another path, or, worse luck, with no path to be found, try again and again to feel your way through the dark trees striving to find some light, somewhere, anywhere. The only thing wrong with this analogy is that being lost in such a forest would be terrifying, whereas science is fun. What is right about the analogy is that science does not run along a straight path like the locomotive but bumbles to the right and left, sometimes backwards, and every once in a while takes a step closer to home, to the ultimate goal, to an understanding of our universe. The last part of that sentence, if you think about it, is astounding. Despite being born naked and ignorant of everything around us we have learned from solely our own efforts that this flat ground we walk on is actually curved, part of a spheroid, that the stars we see are suns, that everything we touch and hold is made up of a hundred or so different particles, that our world has existed not forever but for four and a half billion years, and that many of the stars are billions of years older, in fact that the entire universe is just under fourteen billion years old. This and so much more we know; a truly amazing feat, expressed best by the quote which opens this section—but another quote (by J. B. S. Haldane) serves to balance it: “The Universe is not only queerer than we suppose, but queerer than we can suppose.”

This chapter will cover the nuclear fission option as a future energy supply, and will essentially address the question: can nuclear fission plug the gap until the potential of nuclear fusion is actually realized? (The potential for fusion is considered in detail chapter 7.) To put this question into context, let us first look at some of the key issues associated with nuclear fission, which currently supplies around one fifth of the UK’s electricity. Most large scale power stations produce electricity by generating steam, which is used to power a turbine. In a nuclear power station, the principle is the same, but instead of burning coal, oil, or gas to turn water into steam, the heat energy comes from a nuclear reactor. A reactor contains nuclear fuel, which remains in place for several months at a time, but over that time it generates a huge amount of energy. The fuel is usually made of uranium, often in the form of small pellets of uranium dioxide, a ceramic, stacked inside hollow metal tubes or fuel rods, which can be anything from a metre to four metres in length, depending on the reactor design. Each rod is about the diameter of a pencil, and the rods are assembled into carefully designed bundles, which in turn are fixed in place securely within the reactor. There are two isotopes (or different types) of uranium, and only one of these is a material which is ‘fissionable’—that is to say, if an atom of this uranium isotope is hit by a neutron, then it can split into two smaller atoms, giving off energy in the process and also emitting more neutrons. This, and other pathways, are illustrated in Fig. 6.1 (Source: CEA). Controlling the reaction, so that the energy from the fission of uranium atoms is given out slowly over a period of years, requires two aspects of the process to be carefully balanced. 1. First, there must be enough fissile atoms in the fuel so that—on average— each fission leads to exactly one other. Any fewer, and the reaction will die away.

Let us try to unpack nervous disease. What does it consist of? For one thing, most of the patients are tired, even exhausted, and one of the main components of the nervous picture is fatigue. Today, psychiatrists do not think of fatigue as a terribly important symptom. After such obvious sources as iron deficiency have been eliminated— and it has been determined that the patient is not suffering from one of those quasidelusional disorders such as “chronic fatigue syndrome”—most clinicians would be inclined to ascribe fatigue to depression. For patients, however, fatigue remains a hugely important matter. A study of Stirling County in Canada’s Atlantic provinces in 1970 found that only 6% of psychiatrists considered fatigue to be serious; by contrast, people in the community reported “feeling weak all over” as one of the most serious symptoms among a list of 46. In hospital charts today it is not uncommon to see the acronym “TATT,” Tired All The Time. The complaints of the fatigued and weary echo across the ages. In 1712 Lady Mary Wortley Montagu, en route in a journey, complained to a correspondent, “This is what writing tackle the Inn affords, and my head and hand are both disorder’d with fatigue, both of mind and body.” Lest psychological fatigue be thought mainly a women’s complaint, one of the “grand asthenics” of all time was Parisian novelist Marcel Proust, who, around the turn of the century, was so droopy with fatigue—his medical father had written a book on the subject! —that he barely made it from his bedchamber. His correspondence from 1909, for example, mentions fatigue throughout. On Friday, November 26, after his guests had departed, “I set about demolishing what I had written. And over my heart, fatigued from this absence of repose, voilà the fog that rolls in again. It’s about three in the afternoon and [another nervous] crisis seems to be starting up.” Whatever period or social class is under discussion, fatigue simply tumbles from the page.